0001179110-16-020783.txt : 20160303 0001179110-16-020783.hdr.sgml : 20160303 20160303103809 ACCESSION NUMBER: 0001179110-16-020783 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160303 FILED AS OF DATE: 20160303 DATE AS OF CHANGE: 20160303 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: KEURIG GREEN MOUNTAIN, INC. CENTRAL INDEX KEY: 0000909954 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS FOOD PREPARATIONS & KINDRED PRODUCTS [2090] IRS NUMBER: 030339228 STATE OF INCORPORATION: DE FISCAL YEAR END: 0926 BUSINESS ADDRESS: STREET 1: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 BUSINESS PHONE: 8022445621 MAIL ADDRESS: STREET 1: 33 COFFEE LANE CITY: WATERBURY STATE: VT ZIP: 05676 FORMER COMPANY: FORMER CONFORMED NAME: GREEN MOUNTAIN COFFEE ROASTERS INC DATE OF NAME CHANGE: 20030221 FORMER COMPANY: FORMER CONFORMED NAME: GREEN MOUNTAIN COFFEE INC DATE OF NAME CHANGE: 19930729 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gibbs Stephen L CENTRAL INDEX KEY: 0001358692 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12340 FILM NUMBER: 161479894 MAIL ADDRESS: STREET 1: C/O SCIENTIFIC GAMES CORPORATION STREET 2: 1500 BLUEGRASS LAKES PARKWAY CITY: ALPHARETTA, STATE: GA ZIP: 30004 4 1 edgar.xml FORM 4 - X0306 4 2016-03-03 1 0000909954 KEURIG GREEN MOUNTAIN, INC. GMCR 0001358692 Gibbs Stephen L 33 COFFEE LANE WATERBURY VT 05676 0 1 0 0 VP, Chief Accounting Officer Common Stock 2016-03-03 4 D 0 2627 92.00 D 0 D Stock Option (Right to Buy) 51.56 2016-03-03 4 D 0 2296 D 2023-03-07 Common Stock 2296 0 D Stock Option (Right to Buy) 52.98 2016-03-03 4 D 0 5020 D 2025-12-01 Common Stock 5020 0 D Stock Option (Right to Buy) 54.12 2016-03-03 4 D 0 4269 D 2022-03-22 Common Stock 4269 0 D Stock Option (Right to Buy) 71.30 2016-03-03 4 D 0 3567 D 2023-12-06 Common Stock 3567 0 D Stock Option (Right to Buy) 85.42 2016-03-03 4 D 0 3930 D 2021-08-22 Common Stock 3930 0 D Restricted Stock Units 2016-03-03 4 D 0 213 D Common Stock 213 0 D Restricted Stock Units 2016-03-03 4 D 0 788 D Common Stock 788 0 D Restricted Stock Units 2016-03-03 4 D 0 595 D Common Stock 595 0 D Restricted Stock Units 2016-03-03 4 D 0 424 D Common Stock 424 0 D Restricted Stock Units 2016-03-03 4 D 0 1673 D Common Stock 1673 0 D Performance Stock Units 2016-03-03 4 D 0 637 D Common Stock 637 0 D Performance Stock Units 2016-03-03 4 D 0 997 D Common Stock 997 0 D Disposed of pursuant to the Agreement and Plan of Merger, dated as of December 6, 2015, by and among the Issuer, Acorn Holdings B.V., Maple Holdings Acquisition Corp. and, solely for purposes of Article IX therein, JAB Holdings B.V.(the "Merger Agreement"). Disposed of pursuant to the Merger Agreement in exchange for $92.00 for each share of the Issuer's common stock held by Reporting Person. Pursuant to the Merger Agreement, this option was cancelled as of March 3, 2016 in exchange for a cash payment equal to the product of (i) the number of shares of the Issuer's common stock subject to the option multiplied by (ii) the excess of $92.00 over the per share exercise price of the option. Pursuant to the Merger Agreement, as of the effective date of the Merger, each restricted stock unit, whether vested or unvested, was canceled and converted into the right to receive an amount of cash, equal to the product of (i) the number of shares of the Issuer's common stock issuable upon conversion of such restricted stock unit multiplied by (ii) $92.00 per share. Represents previously unearned performance stock units. Pursuant to the Merger Agreement, as of the effective date of the Merger, each performance stock unit was canceled and converted into the right to receive an amount of cash, equal to the product of (i) the number of shares of the Issuer's common stock issuable upon conversion of such performance stock unit paid out at 100% of target multiplied by (ii) $92.00 per share. /s/ Jessica H. Collins, pursuant to Power of Attorney 2016-03-03